Monday, 27 April 2015

The Mansfield Commission's Interim Report into the Shaping A Healthier Future consultation states of the programme that would rsult in the closure of four of the nine acute hospital sites in the North West London area and the loss of Central Middlesex A&E:

The SaHF programme in our view was a preconceived
solution that was imposed on the North West London health system without there
being any clear problem that it was designed to solve.

In particular there was no proper assessment of
the needs of the whole area to which the health and social care system would
respond.

The following recommendations are made:

1.We recommend that the
SaHF programme is abolished / suspended, thereby saving a considerable sum at
one fell swoop.

2.We recommend that an
independent review of the North West London health system is undertaken under
the auspices of a joint health and local authority initiative that builds its
case on a thorough assessment of the needs for health and social care of local
populations, at local levels.

3.There must be no
presumption that so-called ‘reconfiguration’ of acute services is the solution
to what may not be a problem at all.

4.In addition there
must be no presumption that the solution will involve a top-down approach
across the whole area as SaHF assumed; there should be an openness to
consideration of local solutions possibly at the borough level where these can
be shown to work.

5.The NHS and local
authorities must agree to work together to achieve a joint aim to provide good
accessible health and social care to all local populations within a sustainable
financial model.

6.We recommend that the
attempt to close Ealing and Charing Cross hospitals is immediately stopped;
that a guarantee is given to sustain acute health services on these sites –
with no more double talk from NHS leaders – until the above review is complete
and any associated business cases are taken through to Full Business Case
level, which is likely to be at least five years.

7.We recommend that in
the light of current failures in the system in North West London there is an
independent review of the emergency system under the auspices of the above
joint health and local authority initiative; and that this as a matter of
urgency examines the closure of Hammersmith and Central Middlesex A&E
departments with a view to opening these, if that is what the review suggests
is needed, and what local people want. Local people must be given honest and
genuine choices; the opportunity cost of retaining these sites as A&Es must
be made apparent.

8.We recommend that
there is a review of primary care services in the region, and that following
this review, immediate steps are taken to rectify any issues. However any
investment must be based on a clear business case that relates costs and
benefits to changes across the whole system.

9.Likewise we recommend
that there is a review of OOH services in the region, to establish a clear case
if it exists for OOH acting as a way of reducing demand for acute services, and
also as a way of reducing total system costs. Following this review, any
investment in OOH services must be based on a clear business case that relates
costs and benefits to changes across the whole system.

10.In the case of
changes that take place in primary care and OOH services as a result of the
reviews outlined above, there must be a clear business case presented that
makes a clear case for system- wide improvement arising out of these changes,
and this should be consulted on with the relevant local populations; there
should be no assumption that this is the population of the whole of North West
London.

The full report can be read here:

The
commission's
final public
session will
be held at the Brent Civic Centre on Saturday 9 May 9am-5pm. Brent
Trades Council and Brent Fightback are among those who have submitted
evidence. It would be good to have as many health campaigners as possible at this session. More evidence will be heard

Monday's
Cabinet will be approving the budget to go to the Full Council on March
2nd amidst press coverage of the row over the leadership refusing to
take account of the vote of the Labour Group in favour of a Council Tax
rise.

Meanwhile residents, and particularly the young and parents, have got togather to challenge some of those cuts.

The
Cabinet will be receiving an unusually high number of petitions,
accompanied by speeches from the petition organisers, which indicates
the strength of feeling in the borough.

I am sure they will welcome support from the public at the meeting which starts at 7pm in the Civic Centre.

These are the petitions:

Cabinet – 23 February 2015

Petitions have been received in the following terms in
response to the budget proposals:

1)Keep Stonebridge
Adventure Playground Open “We the undersigned insist that the redevelopment of

Stonebridge School and the new housing, includes
keeping the Stonebridge Adventure Playground open.”

“Youth services are vital for young people as well as the
community and we

believe there will be an adverse effect if the service no
longer exists. This will

put added pressure on statutory services such as the Youth
Offending

Service, the police and social care. We call on Brent
Council to consult with young people effectively before making any cuts to any
youth provision in the borough.

We call on Brent Council to scrutinise existing provision
to ensure that these

resources are appropriate and effective. The young people
of Brent are willing and able to assist Brent Council with this important task.
We call upon Brent Council to consider the voice ofyoung people in the light of
these savings!”

E-petition: started by Roisin Healy (Brent Youth
Parliament)

4)Save
School Crossings Patrols

“Brent Council is under a legal duty to
promote road safety and to promote sustainable transport, such as walking and
cycling.Road traffic accidents are the
biggest killer of children in the UK (they peak when children start primary
school and secondary school). 2011-2020 is the United Nations Decade of Action
for Road Safety. School Patrol Officers are an integral partof the community,
ensuring the safety of our children and they encourage children to have
independence. Many schools in Brent are on busy roads (e.g. Salusbury Primary
School and Islamia on Salusbury Road in NW6) which are only going to get busier
with new housing developments with a new influx of cars and residents. Our
roads should become safer places for our children, not more dangerous. And
children should be encouraged to walk and cycle to school rather than be
driven.”

E petition started by: Michelle Goldsmith on
behalf of local residents .

5)Leopold Primary School
- save our School Patrol

Officer

“Brent Council is considering removing our
Lollipop crossing patrol at Hawkshead Road. The School is surrounded by several
busy roads. We believe this is unacceptable and will directly put our children
in danger of a road traffic accident.”

From:the
Parent, Teachers and Friends Association of Leopold Primary

School

6)Keep Bridge Park
Community Leisure Centre Open

“The centre provides a venue for many members
of ourlocal community and plays a vital
part in our leisure time. Many of us use the facility on a weekly basis to play
football, use the gym, relax in the steam and sauna and meet friends. The
centre hosts children education, courses and activities th at are beneficial to
their development. The centre serves as a venue where rooms can be hired to
many different groups who hold meetings, training and celebrations. Closing
Bridge Park would affect all of us in different ways. We need this Centre to
remain open so that our young people have a place to meet and do sports in a
safe environment.

Stonebridge is a deprived area and we feel
that crime and unsocial behaviour will increase if the centre is closed. Unlike
a few years ago the centre now is used by men and women of all ages and faith.
People come to Bridge Park to get fit and improve their health. Although we
understand that the council funds are limited, the cost of dealing with health
and antisocial behaviour will far outweigh the cost of operating our leisure centre.
We have signed below to show our opposition to the closure.”

Thursday, 12 February 2015

The Independent Healthcare Commission set up by four boroughs and
chaired by Michael Mansfield QC to look into the effects so far of the
implementation of the Shaping a Healthier Future proposals has extend
the deadline for submitting evidence to February 24th. This is the
evidence Brent fightback has submitted:

In addition to the
points made in the BTUC submission which Brent Fightback endorses, we
would like to add that effective out of hospital care, care in the
community, cannot be provided if social care provided by the Council is
slashed.

Brent Council's funding has been drastically cut and
among their proposals to achieve a balanced budget are many cuts which
will severely damage the quality of care available - in particular the
reduction in time from 30 to 15 minutes for carers' visits which has
been widely criticised by elderly peoples' charities as ineffective and
dehumanising. Also the closure of the (ironically titled New Millenium
Day Centre which caters for 80 plus people with complex mental and
physical needs - the group SAHF proposals are supposed to focus on.

Also the withdrawal of any provision for rough sleepers who have a high
level of unmet health needs and already a disproportionately high level
of A&E attendances because they lack alternative means of care.

At the other end of their residents' lives, Brent Council proposes to
close ten of its seventeen children's centres. As well as providing
facilities for play and education, children's centres often host health
services for under-fives including baby and child clinics and advice on
health and diet for parents and their small children. Brent has a very
poor record on child immunisation, dental health, child mental health
and obesity. If these facilities are lost, the NHS primary care services
will be put under even more strain.

This is the Submission made by Brent Trade Union Council

Over many years the Brent Trade Union Council
has campaigned with other concerned organisations and the local trade union
movement about the cuts to the local health service.Our colleagues in the
health service unions warned us that the removal of services from Central
Middlesex Hospital (CMH) would lead to the eventual closure of A & E.

Central Middlesex Hospital was rebuilt and
extensively modernised at a cost of more than £62 million, reopening fully in
2008. This modernisation was funded in large part by PFI and was specifically
designed for emergency medicine.

In spite of this, over the intervening years,
many services have been moved from CMH to Northwick Park Hospital in a far more
prosperous area. Services were transferred without consultation, because there
was no obligation to consult since the two hospitals were part of the same
trust. Staff were often given only a few days' notice that they were required
to transfer and eventually Central Middlesex was left without the back up
services needed for its A & E to remain viable. So we have a situation
where management moved the services, then used it as a justification for saying
that A & E was no longer safe or effective as maintaining an A & E
service is dependent on the full range of hospital services being available to
patients. Yet, right up to the day of its closure the A & E department at
CMH was still being sent patients from the overstretched departments at both
Northwick Park and St Mary's.

Having moved so many services to Northwick Park
and closed the A & E at Central Middlesex, the CCG is now responsible for a
splendid modern building which they will have to pay for until the end of the
PFI contract and the dilemma of how to make use of it.

Throughout these years, Primary care services
have been severely overstretched and continue to be so despite the Shaping a
Healthier Future organisation and the local CCG having a “vision” of improving
those services by investing to prevent illness, lessen the need for hospital
admissions and shorten the length of time patients need to spend in

hospital. Of course the BTUC supports
improvements in primary care, but promises were made that these improvements
would be in place before radical changes were made to hospital services.
However, they remain, to quote the CCG's own documents, “visions” and
“aspirations”.

There is a crisis in recruitment of GPs,
community nurses, health visitors and other staff needed to transform these
visions and aspirations into reality, just as there is a crisis of recruitment
for hospital staff and an expensive and destabilising reliance on agency staff.
BTUC believes that the government's refusal to pay NHS staff even the 1%
advised by their own pay review body and the housing crisis which is extreme in
Brent, contribute to the recruitment crisis in the NHS, while cuts to the
Council's budget threaten the provision of adequate social care, essential if
patients' needs are to be met in the community.

The two Brent wards closest to the hospital,
Stonebridge and Harlesden, are some of the most deprived in the Borough. The
Locality Profile for Harlesden makes for grim reading. Harlesden is ranked in
30s for deprivation for England.

Despite having a young population 32% below the
age of 20 years, in Harlesden ward, life expectancy is 13.4 years for men and
9.6 years for women less than the highest expectancy rate in Dudden Hill
ward. It can be described by a tube train journey. If you take the train from
Harlesden station and travel a few station north you will gain a decade in life
expectancy.

Chronic Illness is significantly higher when
compared to London and England figures, the biggest killers are Cancer,
Circulatory and Respiratory diseases.

Mental illness affects one in six residents, TB
is the second highest in the Borough and HIV is “considered to be very high”
(Locality Profile).

Too many Children are found to be obese in their
reception year when starting school and teenage pregnancies are also high.

We have only outlined a few items from the Brent
Locality Profile for Harlesden Ward but we want to emphasise how completely
unacceptable it is to close the A&E and other services in the middle of a
population that so desperately needs a proper A&E and the important the
general health services that go with it.

To compound this misery the facilities at
Northwick Park which is the A&E that is suppose to replace the CMH
facility, cannot cope with the extra load from the CMH and was rated as the
worst A&E in the country.

The near impossibility of using public transport
to go to Northwick Park. The difficulty of taking a sick child in the middle of
the night to the A&E does not bear thinking about. Again the Harlesden and
Stonebridge wards have the lowest levels of car ownership and minicab costs are
prohibitive for those on low incomes.

Brent Trades Council also want to support and be
associated with the submission from The Hammersmith and Charing Cross Save Our
Hospital Campaigns.

On behalf of the Brent Trades Union Council
please place our submission before Mr Mansfield.

Brent Fighback adds:

In addition to the points made in the
BTUC submission which Brent Fightback endorses, we would like to add that
effective out of hospital care, care in the community, cannot be provided if
social care provided by the Council is slashed.

Brent Council's funding has been
drastically cut and among their proposals to achieve a balanced budget are many
cuts which will severely damage the quality of care available - in particular
the reduction in time from 30 to 15 minutes for carers' visits which has been
widely criticised by elderly peoples' charities as ineffective and
dehumanising. Also the closure of the (ironically titled New Millenium Day
Centre which caters for 80 plus people with complex mental and physical needs -
the group SAHF proposals are supposed to focus on.

Also the withdrawal of any provision
for rough sleepers who have a high level of unmet health needs and already a
disproportionately high level of A&E attendances because they lack
alternative means of care.

At the other end of their residents'
lives, Brent Council proposes to close ten of its seventeen children's centres.
As well as providing facilities for play and education, children's centres
often host health services for under-fives including baby and child clinics and
advice on health and diet for parents and their small children. Brent has a
very poor record on child immunisation, dental health, child mental health and
obesity. If these facilities are lost, the NHS primary care services will be
put under even more strain.

Submissions should be made to: Peter Smith,
Clerk to the Commission, at Hammersmith & Fulham Council. Submissions should be
addressed to him at Room 39, Hammersmith Town Hall, London W6 9JU or sent by
email to peter.smith@lbhf.gov.uk. Later submissions will be forwarded to the
Commission but may not be given the same attention as those received by the
deadline.